2016 II-VI WORKSHOP REGISTRATION FORM
U.S. Workshop on the Physics and Chemistry of II-VI Materials
Sheraton Inner Harbor Hotel, Baltimore, MD
October 17-20, 2016

 
PART I. NAME AND ADDRESS 

First Name
Last Name
Initial

Rank or Title

Company/Gov't Agency/University

Affiliation Address (Street/Avenue)
Mail Stop/P.O. Box/Code

City
State
Zip Code

Country

Phone Number
Fax Number
E-mail
PART II. REGISTRATION 
$795.00 ........ Registration Fee* w/ Electronic Proceedings (Industrial, Government, or University)
$845.00........ Registration Fee* w/ Printed (Soft-cover) Proceedings (Industrial, Government, or University)
$245.00........ Full-Time University Student or Retiree Fee* w/ Electronic Proceedings (Student ID required)
$295.00........ Full-Time University Student or Retiree Fee* w/ Printed (Soft-cover) Proceedings (Student ID Required)
Additional Electronic Copies of the Book of Abstracts

        CD @ $5      USB @ $10
*Fee includes lunches, refreshments, a copy of the Book of Abstracts, and a copy of the Proceedings.
Yes, I will attend (please check all that you will attend):
Monday Tutorial
 Tuesday Breakfast
Tuesday Lunch
Tuesday Night Reception 		Wednesday Breakfast
Wednesday Lunch 		Thursday Breakfast
Thursday Lunch
Do you have any dietary restrictions?
Vegetarian
Kosher
Gluten Free
PART III. PAYMENT INFORMATION
CREDIT CARD:  

CREDIT CARD:  

VISA MasterCard AMEX Diner's Club

Card Number: Expiration Date:
 
Questions or cancellations: Contact Samantha Tola at (800) 350-0111; fax: (212) 460-5460; [email protected]
For a copy of the 2016 II-VI Workshop Advance Program, please visit the official II-VI Website at http://www.ii-viworkshop.org